MR. JEREMY JR. LANE (P.A.-C.) – Surgical Physician Assistant, NPI 1144205220

MR. JEREMY JR. LANE (P.A.-C.) is a healthcare provider. based in St louis park, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.-C.. They hold a License No. 9937 (MN). The NPI Number for MR. JEREMY JR. LANE (P.A.-C.) is 1144205220

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
MR. JEREMY JR. LANE (P.A.-C.)
NPI
1144205220
Phone
(952) 993-3230
Address
3931 LOUISIANA AVE S
Enumeration Date
12 December 2005
Last Update Date
29 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529933123
Graduation Year
2004 (22 years ago)
PAC ID
1456303684
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20050216000584
Address ID
MN554162527ST3850XBLVD400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,032 PHYSICIAN ASSISTANT in MN

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Provider Addresses for MR. JEREMY JR. LANE (P.A.-C.)

  • 3931, Louisiana Avenue South, Brooklawns, Saint Louis Park, Hennepin County, Minnesota, 55426, United States

    ST LOUIS PARK, MN 554265000

    Phone: (952) 993-3230

    Fax: (952) 993-1748

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050216000584IPhysician AssistantMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg2,180132$0
20610Aspiration and/or injection of fluid from large joint257166$0
J1100Injection, dexamethasone sodium phosphate, 1 mg24822$0
99214Established patient office or other outpatient visit, 30-39 minutes175174$0
99213Established patient office or other outpatient visit, 20-29 minutes11293$0
View full utilization report →

Insurance plans in this area (ZIP 55426)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Where can patients find MR. JEREMY JR. LANE (P.A.-C.)'s NPI?
You can confirm MR. JEREMY JR. LANE (P.A.-C.) with NPI 1144205220; it appears in the national provider directory.
Is MR. JEREMY JR. LANE (P.A.-C.)'s NPI currently valid?
The extract we use shows MR. JEREMY JR. LANE (P.A.-C.) as active.
What field does MR. JEREMY JR. LANE (P.A.-C.) work in?
You can think of MR. JEREMY JR. LANE (P.A.-C.) as practicing within Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. JEREMY JR. LANE (P.A.-C.)?
The page summarizes St Louis Park, Minnesota for MR. JEREMY JR. LANE (P.A.-C.); expand the address list for detail.
How can I contact MR. JEREMY JR. LANE (P.A.-C.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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